Dysregulation of MMP and TIMP in Congenital Heart Disease: A Non-Meta-Analysis Systematic Review of Molecular Pathology

Background: Matrix metalloproteinases (MMPs) include a group of factors responsible for cell proliferation, apoptosis, and angiogenesis. Changes in the level of this family are associated with the pathology of structural disorders such as Congenital Heart Disease (CHD). This systematic study assessed previous research to determine the therapeutic potential of MMPs in congenital heart disorders.Method: This systematic review was written based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, and the principle of nonbias was respected. All the articles from ۲۰۱۴-۲۰۲۴ were extracted from the Web of Science, PubMed and Scopus databases. The study investigated the role of MMPs in the pathology of cardiovascular structural disorders, as well as therapeutic and diagnostic effects of MMP and Tissue inhibitors of metalloproteinases (TIMP) levels.Results: A total of studies۱۵ were included in our analysis. MMP-۱, MMP-۲, MMP-۳, MMP-۸, MMP-۱۰, MMP-۱۳, TIMP-۱, and TIMP-۴ were found to be significantly elevated in patients with higher degrees of myocardial fibrosis and diastolic heart failure. MMP-۲ and MMP-۹ levels were significantly increased in hypertensive male patients with bicuspid aortic valve (BAV) and may be associated with an aneurysmal cellular phenotype. MMP-۱۵ plays a critical role in the formation of endocardial cushions, while MMP-۱ may serve as a biomarker for ventricular remodeling in patients who have undergone surgery for tetralogy of Fallot (TOF). Elevated levels of TIMP-۱, MMP-۷ and MMP-۱۲ in patients with postoperative hypoxemia put these children at a higher risk for difficulty weaning off the mechanical ventilator.Conclusion: Regulating of MMP levels during fetal and postnatal periods could lead to the prevention and treatment of CHD. MMP/TIMP homeostasis is considered the key to CHD treatment and is even an important diagnostic tool.

کلیدواژه ها:

congenital heart disease ، Diagnosis treatment ، matrix metalloproteinases ، Systematic review ، tissue inhibitors of metalloproteinases